Experienced Medical Billing and Account Receivable Specialist

Position Overview

Working directly with the insurance company, healthcare provider, and possibly the patient to get a claim processed and paid. You will be required to review and appeal all unpaid and denied claims. This position requires an individual with an extraordinary level of attention to detail and the ability to multi-task. This is a high volume, fast paced and exciting environment.

****Must have 2 years experience.

Description/Responsibilities

• General AR aged by insurance - sorted by company.
• Inquire on every outstanding balance on aging report. (1,200 to 1,500 claims per month), Track and resolve discrepancies, based on partial payment and contracts.
• Take appropriate action from inquiry, which includes logging all actions taken.
• Review, revise, re-process and follow-up on all denials.
• Maintain designated AR over 90 day percentage as defined by the AR Supervisor.
• Keep an Insurance log for "major problems".
• Report recurrent problems to A/R supervisor.
• Fax doctors office for required information to have the claim processed or appealed.
• Follow up on faxes with no response after 10 business days. Refax as 2nd request.
• If no response after 10 business days of 2nd request, hand to supervisor for action.
• Make notes in all account ledgers as to all calls made, faxes done, corrected claims sent, turned to patient responsibility (any action taken).
• Work all correspondence at a minimum of one hour per day.
• Answers questions from patients, clerical staff and insurance companies.
• Identifies and resolves patient billing complaints.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Other Duties:

• Other as assigned by AR Supervisor.
• Keeps work station clean ands organized.
• Reports to AR supervisor recurrent problems via email.
• Must attend all staff meetings and training classes offered.